Efficacy of Using Radiation to Treat In-Stent Restenosis Supported

Efficacy of Using Radiation to Treat In-Stent Restenosis Supported

Radiation therapy is an effective way to open blocked arteries after they were previously opened by angioplasty and stents, and keep them open, providing patients an alternative to invasive surgery, according to a new study presented November 7, 2001, at the American Society for Therapeutic Radiology and Oncology's Annual Meeting in San Francisco.

Between June 1999 and February 2000, the Stents and Radiation Therapy (START) 40 registry trial enrolled 207 patients with single lesion in-stent restenosis within native vessels between 2.7 and 4.0 millimeters. The researchers then compared the results of the START 40 registry to data from the START trial to evaluate the efficacy of treating in-stent restenosis with radiation. A secondary analysis was also performed to identify any toxicity associated with treating patients presenting with long lesions.

The three patient groups analyzed in the study included the placebo arm from the original START trial, the treated group of the START trial and the patients in the START 40 trial. The data from the three patient groups were compared to determine if treating the patients with a longer source train would improve the rates of geographic miss and edge restenosis.

An analysis of the baseline demographics showed that patients in the START 40 trial were older than in the START trial, presented more frequently with unstable angina and had a history of more prior interventions for in-stent restenosis. There were no significant differences seen in the 8-month thrombosis rates. In addition, no significant differences were seen in rates of aneurysm formation or total occlusions.

"The results of the START 40 registry trial support the continued use of Sr-90, beta radiation for the treatment of in-stent restenosis," said Mohan Suntharalingam, M.D., lead author of the study and a member of the Department of Radiation Oncology at the University of Maryland Hospital in Baltimore. "The additional treatment length led to a decrease in the rate of geographic miss with not deleterious effects. The secondary analysis revealed that the beneficial treatment was maintained throughout all lesion lengths analyzed without increased toxicity."

If you would like a copy of the abstract titled "Analysis of Clinical Outcomes from the START and START 40 Trials: The Efficacy of Sr-90 Radiation in the Treatment of Long Lesion In-Stent Restenosis" or to speak to the lead author of the study, Mohan Suntharalingam, M.D., please call Katherine Egan Bennett at the ASTRO Press Room at the Moscone Convention Center at (415) 978-3717 or e-mail her at [email protected]. Alternatively, you call contact Lesley Nevers at ASTRO's headquarters at (703) 227-0141 or e-mail her at [email protected] for more information.

ASTRO is the largest radiation oncology society in the world, with more than 6,700 members who specialize in treating patients with radiation therapies. As a leading organization in radiation oncology, biology and physics, the society's goals are to advance the scientific base of radiation therapy and to extend the benefits of radiation therapy to those with cancer and other diseases.

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